The Surgical Procedure
The surgery is performed under general anaesthesia associated with spine anaesthesia to decrease general medication and speed-up recovery.
Surgery takes 2 hours per femur or tibia. In case of bilateral lengthening, an overall time in operating room of 5-6 hours is noted.
Thanks to protocols Dr. Guichet developed over years, the loss of blood is minimal (1 to 2 grs of Hemoglobin for a bilateral lengthening) allowing bike on the day of - or first day - after surgery, and mainly to suppress the need for blood transfusion!
Anaesthesia plays a major role for recovery. For decreasing blood loss, Dr. Guichet uses the most advanced techniques: morphine epidural or spine anaesthesia, specific general anaesthesia, continuous blood hypo-pressure, etc.
A very tiny incision, approximatively like for arthroscopic procedures is performed on the top of the concerned bone (femur, tibia ou humerus), in the alignemnt of the bone canal. The bone canal is drilled and reamed, then the bone is sectioned from the inside using a special intramedullary saw set in the body through the top scar. This prevents new incisions in front of the bone section, which creates a loss of bone healing material.
The nail is then inserted inside the bone, through the upper stab incision, then locked into the bone with 1 upper and 2 lower screws, thanks to the most advanced sighting device available for nails in the world, necessitating the lowest doses radiations during surgery (from 5 to 20 times less radiations than with other nails), maintaining short surgical times to insert screws.
The screws are extremely strong and, as a matter of fact, the strongest ones on the market, in a recent engineering comparative study.
Dr. Guichet and his operative Team during initial defriefing in operating room.
Dr. Guichet and his Team installing in operating room the patient.
Dr. Guichet and her Assistant, Dr Ranieri, closing the skin with intradermal suture.